| NPI | 1649556630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DIERKING Owner 636-253-0761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: MO 2011000036) |
| Enumeration Date | 2011-10-23 |
| Last Update Date | 2013-09-11 |